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S~T ATE OF FLORiDA
DEPARTMENT OFREVENUE
5`''f ~STATE TAX BUREAU
" ~ ~ TAl_t_ 4HASSEE. FIORIDA 32304
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1 FD 5*wwJGnN NON - TAXABLE CERTIFICATE AND RECEtPT
~~"~'~~`'Q"~~" FOR ESTATE TAX
1~~~~ Mr. William Scofield Spouse C 10 3 519
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c/o Mr. T. J. Hawkins, Atty.
P.O. Box 1186
Lake Worth, FL 33460 The Estate of
• Caroline C. Sco~ield
Deceased.
Hesident of Palm Beach
County. Florida
I?ate October 2, 197 3
S5 . 00 $ (}p-~e Received : same
TH1~ IS "f0 CERTIFY, That in accordance with the provisions of Chapter 198,
G'lorida Statutes, there ha~ been filed with this uffice a sworn report or return fur ~:state
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Taae~ ~y required b~~ law and on the basis thereof ii ~as ueen ascei~~«~~~ y.......
n~; subje. t tc~ the Florida N:state Taa . The igsua~ice of this certificate, howe~ er, shait
not preclude the assessment and coiteciion of ~;staie Taxes subsequently determined to be
due the State uf Florida.
[f proof of non liability b~~ the above estate for the Flurida ~;state Tax is requ~red
hy anv pe~3nn this Certificate ma~• be exhibited a~ e~•idence of such non liability.
~ Given in quadruplicate under my hand and the seal of the State of Florida the
~ ~iaie first above written.
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a - I~partment of Revenue
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Not valid without sea! aff xed .
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